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First published on August 29, 2007, doi:10.1177/1090198106290622

Health Education & Behavior 2008;35:376.

A more recent version of this article appeared on June 1, 2008

Article

Evaluation of Community Action Against Asthma: A Community Health Worker Intervention to Improve Children's Asthma-Related Health by Reducing Household Environmental Triggers for Asthma

Edith A. Parker, DrPH, MPH1*, Barbara A. Israel, DrPH, MPH1, Thomas G. Robins, MD, MPH2, Graciela Mentz, PhD1, Xihong Lin, PhD3, Wilma Brakefield-Caldwell4, Erminia Ramirez, MSW5, Katherine K. Edgren, MSW6, Maria Salinas7, and Toby C. Lewis, MD, MPH8

1 Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor
2 Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor
3 Department of Biostatistics, Harvard School of Public Health, Boston
4 Community Partner at Large, Community Action Against Asthma, Detroit
5 Community Health and Social Services (CHASS), Detroit
6 Student Health Services, University of Michigan, Ann Arbor
7 National Community Development Institute, Detroit
8 Department of Pediatrics, University of Michigan School of Medicine, Ann Arbor

* To whom correspondence should be addressed. E-mail: edithp{at}umich.edu.


  Abstract
This article describes the evaluation of a community-based participatory research (CBPR) community health worker (CHW) intervention to improve children's asthma-related health by reducing household environmental triggers for asthma. After randomization to an intervention or control group, 298 households in Detroit, Michigan, with a child, aged 7 to 11, with persistent asthma symptoms participated. The intervention was effective in increasing some of the measures of lung function (daily nadir Forced Expiratory Volume at one second [p = .03] and daily nadir Peak Flow [p = .02]), reducing the frequency of two symptoms ("cough that won't go away," "coughing with exercise"), reducing the proportion of children requiring unscheduled medical visits and reporting inadequate use of asthma controller medication, reducing caregiver report of depressive symptoms, reducing concentrations of dog allergen in the dust, and increasing some behaviors related to reducing indoor environmental triggers. The results suggest a CHW environmental intervention can improve children's asthma-related health, although the pathway for improvement is complex.
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